Chemotherapy side effects: hair

Hair loss (alopecia) is a common side effect of chemotherapy. Not all drugs cause hair loss and some drugs only cause thinning of the hair or cause it to become brittle.

Possible side effect: hair loss.

When symptoms may occur: Within a few weeks of beginning a course of chemotherapy.

Symptoms include:

Total hair loss

Thinning of hair

Brittle hair

What you should do:

Use a neutral pH shampoo and conditioner

Cut down on the number of times you wash your hair each week

Order a wig in advance if you are likely to lose you hair

Avoid harsh chemicals, such as hair dyes and perms

Hair loss

Hair loss can be very distressing, however it is always temporary and your hair will grow again when treatment finishes. Occasionally, hair will start to grow back before the end of chemotherapy. Sometimes, hair may grow back a different colour or texture.

Hair loss does not always happen straight away and usually starts within a few weeks of beginning treatment. Sometimes it starts within a few days. It can occur on all parts of the body, including the head, face, arms and legs, underarms, and pubic area. If you lose hair around your eyes or in your nose, you may experience a runny nose and weepy eyes because of this.

‘Cold cap’

For some types of chemotherapy, cooling the scalp with a ‘cold cap’ as the drug is given can prevent hair loss. This works by reducing the blood flow to the scalp so that less of the drug reaches the hair follicles on your head.

However, the cold cap doesn't work for everyone. It only blocks certain drugs and isn’t suitable to use with all types of cancer. Your doctor or nurse will be able to tell you if this is appropriate in your case.

If you have a cold cap, you will need to allow extra time at the hospital for your treatment.

Wigs

Wigs, available on the NHS and privately, can be obtained in advance if you are likely to lose your hair.

Caring for your hair

Chemotherapy can cause your hair to become dry and brittle, so take good care of it. Use a neutral pH shampoo and conditioner (baby shampoo is too alkaline). Cut down on the number of times you wash your hair each week.

Use a wide-toothed comb to avoid pulling at your hair and hair roots. Avoid harsh chemicals, such as hair dyes and perms, and excessive heat from heated rollers and hair dryers during chemotherapy and for a few months following completion of chemotherapy.